Spondyloarthritis
Spondyloarthritis
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DOI：
10.1016/s0140-6736(11)60071-8
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发表时间：
2011-06-18
期刊：
影响因子：
168.9
通讯作者：
Baeten, Dominique
中科院分区：
文献类型：
--
作者：
Dougados, Maxime;Baeten, Dominique
脊柱关节炎是一组几种相关但表型不同的疾病：银屑病关节炎，与炎症性肠病相关的关节炎，反应性关节炎，幼年特发性关节炎的一个亚组，以及强直性脊柱炎（原型和最好的研究亚型）。在过去的十年中，在脊柱关节炎作为一个实体的认识、疾病的分类以及对疾病相关炎症和组织损伤的遗传和病理生理机制的理解方面取得了重大进展。与此同时，新的临床和影像学结果允许评估各种治疗方式。肿瘤坏死因子的阻断剂是一个主要的治疗进展，但物理治疗，非甾体类药物治疗和其他生物治疗的确切作用尚不清楚。未来十年与临床实践直接相关的主要挑战是早期诊断技术的发展，结构损伤的治疗调节，以及最终诱导长期无药物缓解。
Spondyloarthritis is a group of several related but phenotypically distinct disorders: psoriatic arthritis, arthritis related to inflammatory bowel disease, reactive arthritis, a subgroup of juvenile idiopathic arthritis, and ankylosing spondylitis (the prototypic and best studied subtype). The past decade yielded major advances in the recognition of spondyloarthritis as an entity, the classification of the disease, and understanding of the genetic and pathophysiological mechanisms of disease-related inflammation and tissue damage. In parallel, new clinical and imaging outcomes have allowed the assessment of various therapeutic modalities. Blockers of tumour necrosis factor are a major therapeutic advance, but the exact roles of physiotherapy, and treatment with non-steroidal antiinflammatory drugs and other biological treatments are unknown. The major challenges with direct relevance for clinical practice for the next decade are the development of techniques for early diagnosis, therapeutic modulation of structural damage, and, ultimately, induction of long-term, drug-free remission.